Smoothing the Bumps in the EHR Road

Overview

A major part of the American Recovery and Reinvestment Act of 2009 is the Health Information Technology for Economic and Clinic Health Act (more commonly known as the HITECH Act), which promoted the adoption of electronic health records (EHR) and, ultimately, a network that will connect them all. The goal is that, someday, a patient can go into any facility anywhere in the U.S. and the healthcare professional will have all of the patient’s background information, making treatment faster and more effective. Healthcare providers are incentivized to implement EHRs within their practice and to establish ‘meaningful use,’ which means instituting all the required elements of a functional and beneficial electronic record system. Implementing these systems, however, is easier said than done. This complex, multifaceted technology must be integrated into all systems and processes of a healthcare facility -- while the facility continues to function. As the saying goes, they must build the plane while flying it. Added to that, the technology is expensive -- even with incentives from the government -- and encouraging adoption among staff who worked much of their careers without it can be a major hurdle. The organizational impact of moving to computerized physician order entry (CPOE) and the processes required to make it successful are one of the greatest challenges hospitals have taken on.

The Challenge

North Valley Hospital, a 25-bed critical access hospital in Montana, completed implementation of a new EHR system in December 2013, but faced issues with acceptance by staff and integration into the hospital. To continue the implementation process and smooth the transition to the new system, the facility brought in Quorum Health Resources (QHR) and one of its experienced IT consultants. The consultant’s knowledge of the process and pitfalls of EHR implementation, along with an outside perspective, brought the momentum North Valley Hospital needed to successfully move the project forward.

QHR Solutions

To begin, the consultant tackled the EHR system itself with the following steps:

• Organized the tracking and resources needed to build system changes;

• Prioritized which changes to make first;

• Supported the changes with best practices;

• Advocated for the client with the EHR vendor; and

• Arranged for the speech recognition software company to provide additional training as well as technical optimization to help the physicians become more comfortable with the tools and reduce system errors.

The consultant then looked to the IT department to ease its pain points. The consultant began by helping IT restructure the help desk support into two areas: General IT support and Clinical Informatics support. This reorganization helped get the right requests to the right person as quickly as possible, and with 24-hour clinical support, the nurses and physicians on the floor could get their questions answered in real time.

Most importantly, the consultant addressed communications in a variety of areas. IT and the clinical informaticists now had to work closely together, despite coming from different technical backgrounds. Leadership had to engage a hesitant physician staff and create a balance between listening and understanding the position of the physicians while ensuring implementation moved forward. Opening up these channels of communication helped improve adoption and optimized the EHR so that it could efficiently and effectively support the clinical and business operations of the hospital.

Results

While no program works perfectly, changes in technology alone cannot make or break a system. The hospital—its people and its processes—must adjust to make new technology successful. North Valley continues to strive for excellence in their new system and have since remained qualified for annual Meaningful Use attestation. Bringing in a QHR consultant gave them the insight and experience they needed to continue pushing forward to develop a system that will support North Valley Hospital into the future.